The Th2 response and several subjects in the current study belonging to different symptomatic subgroups and recovered group showed intense elevation. IL-13 is considered to an important immunomodulatory cytokine which also induces B cell proliferation and IgE switching. IL-13 was reported to play an important role in the hypersensitive and allergy responses in the respiratory tract and gut and is implicated with fibrosis in scleroderma. In the current study, there were no differences in the IL-13 assay results obtained in the acute, sub acute and convalescent cases. We are not able to find a satisfactory explanation for persistent heightened IL-13 response in the study. We speculate that IL-13 may be associated with persistent arthritis in CHIKV. Several other researchers have published data on cytokines in CHIKV. We have chosen some of the studies for comparison. It is prudent to add that precise comparison is not appropriate for several reasons pertaining to small sample size, timing of blood collection and assay methods. Our focus was on cytokines in acute illness and persistence of musculoskeletal symptoms from 14–30 days after onset of illness. Increased IL-1, IL-10 and IFN-c assay reported suggests an early engagement of adaptive immunity. On comparison, discrepant results were observed in the study reported by Kelvin et al where the median levels of IL-4 and IL-10 was lower in the acute cases than in the healthy controls. Increased levels of IL-2R was reported in acute CHIKV cases. Also, Chaaithanya et al have also reported high levels of IL-1 receptor antagonist in acute CHIKV cases. We used published data and we chose acute or early illness. The ratio of several cytokines in the current study was several fold higher than that calculated for other studies. To provide an interesting perspective to the intense cytokine phenotype in the current study we also included a similar cytokine assay ratio profile from a study of patients suffering from Rheumatoid Arthritis which is a prototype of an intense immune inflammatory disorder. Vemurafenib However, unlike CHIKV, RA is a chronic disorder and an upregulation of immune cytokine response is reported several years prior to onset of the clinical disease. Infrequently, CHIKV can lead to chronic persistent painful MSK illness and arthritis and was the subject of our earlier publications. The current study had several limitations. Compared to the large number of clinically identified cases, much lesser number of cases consented to donate blood samples. Cases identified during the survey had varying period of illness and in several the clinical diagnosis was based on historical narration. We did not use concurrent controls but chose blood samples collected a year earlier to CHIKV epidemic to avoid sub-clinical illness during the epidemic. Despite the fact, that we made frequent visits to the study village during the epidemic period, we managed to collect blood samples of only 23 acute cases.